Do Electronic Health Records save money? That is the question that author Stephen Strauss explores in his latest article on Electronic Health Records published by CBC News. The evidence presented is quite striking. In an excerpt from the article, Strauss states:
Ask any of the radiologists, specialists or emergency physicians whether they would go back to film and paper reporting and I doubt that any would wish to move back to the previous state. Digital imaging is infinitely better and more accessible to physicians and patients, however there is no doubt that this type of technology is expensive. It is unrealistic to expect that in the shorter term there would be any savings."The Western Newfoundland Health Authority encompasses about 80,000 people and includes Corner Brook and Stephenvillle. It was studied because until 2005 it was virgin territory for PACS. No electronic imaging capabilities were in place whatsoever. Two years later, all imaging is electronic. This allowed Don MacDonald, a senior analyst who has been conducting ehealth benefit analyses for seven years with the Newfoundland Centre for Health Information, to do an exhaustive before-and-after study. What his study found — please sit down — was that rather than saving anything, the inflation-adjusted cost per examination of computerized X-rays, MRIs and CT scans has gone up from $9.50 to $11.80."
"Sam Marafioti, chief technology officer at Sunnybrook Hospital, which has been in the forefront of Canadian EHR record implementation, radiates cost/benefit doubt during an interview: "People who have the best intention in marketing the benefits of EHR, they oversell it. And I fundamentally disagree with all of those studies that say there are billions of dollars to be saved. It is just not going to materialize." A recent study of 3,000 U.S. hospitals in the process of changing to digital records found no significant cost benefits. But Canada Health Infoway strongly resists such negative conclusions....
Measuring the return from electronic health records is murky math, at best
We still have a very disconnected healthcare system from a technology perspective, have not reached a critical mass in terms of physician adoption of EMRs and have significant policy and legislative gaps. Compound this with a lack of national vision and leadership with regard to EMRs, EHRs and user adoption and we are going nowhere fast.
Sorry Infoway, the EHR Blueprint that you crafted 7 years ago is old and stale. We need new ideas, new strategies and we need to know what did not work. It is getting pretty tiresome hearing the same old stories about PACS, Synoptic Reporting and Alberta Netcare. How about a forensic review of all of the national and provincial projects that did not work and and an analysis of why they went wrong. Now, that would be very useful!
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As a frequent visitor to Canada I have to express some strong support for your comments Alan. Every time I visit I am astounded at the very lacklustre connectivity that general practices have with the rest of the health sector. For a country that is pouring so much money into health IT, the results are pretty thin on the ground. In other countries with similar health systems, clinical messaging has already replaced most paper and GPs have almost universal uptake of high quality EMR systems. Why is Canada so different?
Posted by: Tom Bowden | December 07, 2009 at 07:53 PM
The problem is that although the article refers to cost/benefit analysis, it really does not consider benefit other than reduced cost. This is not really a cost/benefit analysis because it has not put a monetary value on the increased benefit, which article acknowledges is present. Enhanced quality of service is definitely a benefit, but it has not been factored into the ratio (understandably).
Posted by: Denise Kouri | December 15, 2009 at 07:49 AM